solar & atrilaze atrial fibrillation trial

Conditions: Atrial Fibrillation

Summary: the purpose of study is to conduct a pivotal evaluation of the endophotonix™ solar™ system and atrilaze™ system in order to obtain a labeling claim on the devices for the treatment of atrial fibrillation. the study will test the safety and effectiveness of the endophotonix™ laser ablation systems to photocoagulate cardiac tissue during cardiac surgery, to create electrical isolation of the pulmonary veins and create other electrical isolation lesions in order to treat atrial fibrillation. the surgical procedure will be conducted during concomitant mitral valve repair or replacement surgery or in combination with other cardiac surgery including aortic valve surgery, tricuspid valve surgery, or coronary artery bypass surgery.

the study objective is to generate level ii controlled data to support the expansion of indications for the solar™ system based on 0-30 day data; as well as to support the expansion of indications for the solar™ system and atrilaze™ system for the treatment of atrial fibrillation based on 180 days data. the data will be evaluated by comparing post-operative data to the historical control data. the subjects in the study cohort will receive laser ablation therapy using the investigational device during a concomitant surgical procedure.

Eligibility criteria:
inclusion criteria: * age at least 18 years * documented long term persistent atrial fibrillation (also known as permanent af).of at least 3 months duration. persistent af is defined as af which is sustained beyond seven days, or lasting less than seven days but necessitating pharmacologic or electrical cardioversion. long term persistent af is defined as continuous af of greater than three months duration. * concomitant indication for open heart surgery for at least one of the following: * mitral valve repair or replacement * aortic valve repair or replacement * tricuspid valve repair or replacement * atrial septal defect (asd) repair * patent foramen ovale (pfo) closure * coronary artery bypass procedure * be able to take anticoagulation therapy (warfarin / coumadin®) * be able to fulfill study requirements * willing and able to comply with the requirements of the protocol including follow-up requirements * willing and able to sign a study specific informed consent exclusion criteria: * life expectancy \< 1 year * nyha class = iv * left ventricular ejection fraction (lvef) measurement \<30% * left atrial diameter \> 7.5 cm * wolff-parkinson-white (wpw) syndrome * pregnancy or desire to be pregnant within 1 year of the study treatment * myocardial infarction within the previous 6 weeks * presence of a previously implanted device (valve, cs leads, or icd) * known allergy, contraindication, or inability to comply with warfarin (coumadin®) or heparin therapy * known allergy or contraindication to complying with anti-arrhythmic (class ia, ic, iii) therapy * previous thoracic procedure resulting in sternal opening and/or pericardial opening (e.g., cabg, valve replacement or repair) * current diagnosis of active endocarditis, local or systemic infection * renal failure requiring dialysis or hepatic failure * emergent cardiac surgery (cardiogenic shock) * preoperative need for intra-aortic balloon pump, iv inotropes or vasoactive agents * currently participating in another clinical research study * cerebral vascular accident or transient ischemic attack within previous 180 days or at any time with a documented residual neurological deficit

Keywords: ablation af atrial fibrillation cardiac endocardial endocardium ep electrophysiology epicardial epicardium heart interventional lesion pvi pulmonary vein maze surgery surgical treatment patients with persistent af with 3 months duration requiring concomitant open heart surgery